Provider Demographics
NPI:1891904629
Name:MOORE, CYNTHIA ROYER (PCC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ROYER
Last Name:MOORE
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 DRESSLER RD NW
Mailing Address - Street 2:SUITE #130
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3667
Mailing Address - Country:US
Mailing Address - Phone:330-649-7373
Mailing Address - Fax:330-649-7377
Practice Address - Street 1:4801 DRESSLER RD NW
Practice Address - Street 2:SUITE #130
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3667
Practice Address - Country:US
Practice Address - Phone:330-649-7373
Practice Address - Fax:330-649-7377
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0003491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health